flow clinical cases
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Flow Imaging
Clinical Cases
Typical Velocities (cm/sec)
Pulmonary Artery
70-130
Aorta
100 – 175
Carotid Artery
80 – 120
External Iliac Artery
81 – 120
Carotid Syphon
55
Common Femoral Artery
115
Basilar Artery
40
Superficial Femoral Artery
90
Vertebral Artery
40
Popliteal Artery
70
Sagittal Sinus Vein
10
Peripheral Veins
5 – 10
Qp/Qs: Atrial Septal Defect
Trufisp Cine
Trufisp Cine
ASD not easily seen
ASD not easily seen
Contrast Bolus
First Pass Exam
Contrast Bolus
First Pass Exam
ASD is easily seen
ASD is easily seen
Dr. John Lesser and Dr. M. Tadavarthy, Abbott Northwestern Hospital, Minneapolis, MN
Qp/Qs: Atrial Septal Defect
Flow Imaging is
Perpendicular to Main
Pulmonary Artery
VENC = 150 cm/sec
Flow Imaging is
Perpendicular to Aorta
VENC = 150 cm/sec
Qp/Qs: Atrial Septal Defect
pulmonary artery
aorta
Qp/Qs: Atrial Septal Defect
net flow
130 ml
pulmonary artery
stroke volume
130 ml
net flow
80 ml
ascending aorta
stroke volume
80 ml
Qp/Qs: Atrial Septal Defect
pulmonary artery
ascending aorta
• shunt fraction (Qp/Qs ratio) = 131 / 82 = 1.6
• shunt from left atrium to right atrium
• known as systemic to pulmonary shunt
Pressure Gradient: Pulmonary Valve Stenotic Jet
Pulmonary Outflow
Short Axis
Dr. John Lesser and Dr. M. Tadavarthy, Abbott Northwestern Hospital, Minneapolis, MN
Pressure Gradient: Pulmonary Valve Stenotic Jet
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Truefisp Cine image through pulmonary valve shows the jet.
Rephased Flow image with in-plane VENC 500 cm/sec shows the valve.
Phase Flow image with in-plane VENC 500 cm/sec shows the jet.
Pressure Gradient: Pulmonary Valve Stenotic Jet
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Orthogonal slice was placed directly through the jet.
Truefisp Cine image through pulmonary valve shows the valve & jet.
Phase Flow image with in-plane VENC 500 cm/sec shows the jet.
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Pressure Gradient: Pulmonary Valve Stenotic Jet
• Flow Imaging of Stenotic Jet with Inplane VENC 400 cm/sec
• Agrees with Peak Velocity of 400 cm/sec Measured at Cardiac Catheterization
Regurgitant Fraction: Aortic Valve Insufficiency
TrueFisp Cine Imaging
of Aortic Valve
Flow Imaging with
Through-plane VENC
of 150 cm/sec has
aliasing
(must raise VENC)
Dr. John Lesser and Dr. M. Tadavarthy, Abbott Northwestern Hospital, Minneapolis, MN
Regurgitant Fraction: Aortic Valve Insufficiency
VENC -150 to +150 cm/sec has aliasing
(before VENC Adjustment, peak velocity 144 wrong)
Regurgitant Fraction: Aortic Valve Insufficiency
VENC –130 to +170 cm/sec has NO aliasing
(after VENC Adjustment, peak velocity 167 correct)
Regurgitant Fraction: Aortic Valve Insufficiency
regurgitant fraction = 25 / 101 = 25%
stroke volume = 76 ml
